CMS Price Transparency Data

Psychological testing by technician

Facility: Pine Rest Christian Mental Health Services

Billing Code: 96138 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96138
Insurance Median: $37
Cash Discount Price: $52
vs. Medicare Baseline: 0.08x Medicare

The contracted insurance negotiated median rate for a Psychological testing by technician at Pine Rest Christian Mental Health Services is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $456.4, this hospital’s rate is 0.08x the Medicare baseline. Located in 300 - 68Th Street, Se, Grand Rapids, MI.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$456.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $456.4 (100%)

Cash / Self-Pay: $52 (11%)

Insurance Median: $37 (8%)

Cash: $52 (11% of Medicare)

Ins. Median: $37 (8% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $456.4 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$16 - $31	4%
UnitedHealthcare	$16 - $40	4%
Priority Health [1300]	$18 - $51	4%
Aetna	$22 - $63	5%
Blue Cross Blue Shield	$22 - $57	5%
Champva [1117]	$31	7%
Humana	$31	7%
Medicare (plans)	$31	7%
Molina [1156]	$31	7%
Tricare	$31	7%
Veterans Administration [1174]	$31	7%
University Of Michigan Health Plan Comm [1159]	$35 - $47	8%
University Of Michigan Health Plan [1205]	$35 - $47	8%
Beacon/Carelon Behavioral Health [1198]	$36	8%
Behavioral Health Systems [1115]	$38	8%
Golden Rule [1131]	$40	9%
Healthscope Benefits [1140]	$40	9%
Ubh [1167]	$40	9%
Asr Physicians Care Health Plan [1160]	$42 - $50	9%
Hap Ppo/Health Alliance Plan [1134]	$42 - $50	9%
Blue Care Network [1000]	$43 - $48	9%
Cofinity [1120]	$47 - $63	10%
Geha [1129]	$47 - $63	10%
Meritain Health Plan [1153]	$47 - $63	10%
Compsych [1122]	$48	11%
Cigna	$50	11%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $52.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96138.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pine Rest Christian Mental Health Services is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96138.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.